HomeMy WebLinkAboutPermit Mechanical 2005-10-12
.
Status: Issued
225 Fiftb Street, Springfield, OR
541-726-3753 Phone
_ 541-726-3676 Fax
541-726-3769 Inspection Line
. CITYOFSPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01429
ISSUED: 10/12/2005
APPLIED: 10/12/2005
EXPIRES: 04/12/2006
VALUE:
. SITE ADDRESS: 2936 MANOR DR
ASSESSOR'S PARCEL NO.: 1703233200500
Springfield TYPE OF
Heating System
. TYPE OF USE: New
Residential
PROJECT DESCRIPTION: InstaU gas insert and piping
Owner: MAMIE LANG
Address: 2936 MANOR DR
SPRINGFIELD OR 97477
Contractor Type
Mechanical
Phone Number: 541-746-8821
I CONTRACTOR lNFORMA TlON I
Contractor
AMBASSADOR PIPING INC
Phone
541-726-5723
_ # of Units:
Primary Occupancy Group:
Secondary Occupancy
Yrlmary Construction Type
Secondary Construction
# of Bedrooms:
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
, Street
Storm Sewer Available:
Special Instruction:
Notes:
Description
Tvpe of Construction
License
121469
Expiration Date
03/27/2007
R-3
I BUILDlNGlNFORMATlONI
jJfSi1ir~ Oregon la . Lot Size:
N fO~l;lgliflof; adopted b ~ reqUIres YOISq,Ft 1st Floor:
. ot1'~~olllJ~!;er. Tho; e Oregon UISq,Ft 2nd Floor:
In OWateii:TYI!~:OOl 0 thr e rules are Sp! Sq Ft Basement:
OOg'Range ifYl}ebbtain oUgh OAR 9s:?_Sq Ft Garage/Carport
CCE;oergy..Patb:t copies of tha n'" Sq Ft Other:
oJ .e.....CII ef. (N t I
nUlSim!'IE."'~le O' 0 e: the n/a: " Occupant Load:
rennn 11f"1;~,. ..
1. ._...~- , . . - ~ -..".....11
I DEVELOPMENT INFORMl\TlON.I.
VN
REQIDRED PARKING
Overlay Dist:
# Street Trees
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
IPUBLlC IMPROVEMENTS I
!\fOT6C~. Sidewalk Type:
TH IS.
AU'S PERMI'i'~~, n ~ DownspoutslDrains
THORllEO <>l!>~~O~
COMMEMCEi) ~%DE~ flM~ C1l~~~ ~C{
Aftjtf 800 ~ (;l~~~~OOfJ r<<Jr .
\)
I Valuation Descriotion I
$ Per Sq Ft
or multipUer
Square Footage
or Bid Amount
Value
Date Calculated
1 of 2
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01429
ISSUED: 10/12/2005
APPLIED: 10/12/2005
EXPIRES: 04/1212006
VALUE:
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Pllid I
Fee Description
-Mechanical Issuance Fe.....
+ 10% Administrative Fee
+ 7% State Surcharge
~ Gas Fireplace
Gas Outlets 1-4
Minimum/Adjustment Mechanical
Amount Paid
Date Paid
$10.00
$4.50
$3.15
$15.00
$4.00
$26.00
10/12/05
10/12/05
10112/05
10112/05
10112/05
10112/05
Receipt Number
1200500000000001505
'1200500000000001505
1200500000000001505
1200500000000001505
1200500000000001505
1200500000000001505
Total Amount
$62.65
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
~ 1?1~:n1/vr~ Tn~
~ Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
By signature, I state and agree, that I have carefuUy examined the completed application and do hereby certify that aU
Information hereon is true and correct, and I further certifY that any and aU work performed shall be done in accordance
with the Ordinances of tbe City of Springfield and the Laws of the State of Oregon pertaining to the work described herein,
and that NO OCCUPANCY wiD be made of any structure without permission of the Community Services Division,
Building Safety. I further certifY that only contractors and employees who are in compliance with ORS 701.005 will be used
on this project.
I further agree to ensure that aU required inspections are requested at the proper time, that each address Is readable from
the street, that the permit card is located at the front ofthe property, and the approved set of plans wiD remain on the site
at aU ti41~_o~tr~on. -:::
~~ /IJ - /~ .",,-
Owner or Contractors Signature Date
2 of 2
225 Fifth Street
Springf1eld, Oregon 97477
541-726-3759 Phone
.
8P~\U'N.'~"'~ __," '.'
~'
f i
. I
,-., J
1iJ.ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
Job/Journal Number
COM2005-0 1429
COM2005-01429
COM2005-0 1429
COM2005-0 1429
COM2005-0 1429
COM2005-0 1429
Payments:
Type of Payment
Check
"
:l
:c
:t
'l
'(
~\
'{
10/12/2005
:,
RECEIPT #:
1200500000000001505
Date: 10/1212005
Description
+ 7% State Surcharge
+ 10% Administrative Fee
Gas Outlets 1-4
Gas Fireplace
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
Paid By
AMBASSADOR PIPING
Recel ved By
djb
I of I
Item Total:
Lbeck Number Autb.onzatlon
Batcb Number Number How Received
8869 In Person
Payment Total:
9:29:0IAM
Amou nt Due
3,15
4,50
4,00
15.00
26,00
10,00
$62.65
Amount Paid
$62.65
$62.65